Story 1: Recommend U.S. Naval Station Guantanamo Bay Be Used For Quarantine and Isolation of U.S. Troops Returning From Ebola Response Missions in West Africa and Care of Ebola Patients in 100 Bed Bio-Safety Level 4 Containment Center! — Videos

21-Day Quarantine For Troops Returning From Ebola Hot Zones

Pentagon orders 21-day Ebola quarantine for troops

Hagel Approves 21-day Ebola Quarantine For Troops

Hagel Approves 21-day Ebola Quarantine For Troops

USAMRIID The US Army Medical Research Institute of Infectious Disease

USAMRIID Overview

BioContainment Unit at The Nebraska Medical Center

Activation- A Nebraska Medical Center Biocontainment Unit Story

Questions & Answers About Ebola – Doctors – Nebraska Medicine

Phil Smith, MD, medical director of the Biocontainment Unit at Nebraska Medical Center and Angela Hewlett, MD, associate medical director of the unit, provide answers to some commonly asked questions about the disease – both for providers and the general public.

Questions & Answers About Ebola – Nurses – Nebraska Medicine

Biocontainment Unit nurses Kate Boulter and Morgan Shradar answer questions for providers and the public about treating patients with the Ebola virus. For more information, visit http://www.NebraskaMed.com.

US Ebola Nurse Kaci Hickox Fighting Quarantine ‘Completely Healthy’

WATCH: Kaci Hickox breaks her quarantine, gives CNN biking interview

Ebola Nurse Goes for Bike Ride – Quarantine Be Damned

Ebola Nurse Kaci Hickox Goes on Bicycle Ride

GOVERNMENT AGENCIES SCRAMBLE TO PURCHASE HAZMAT SUITS

Orders from one company surpass 1 million as concerns about Ebola linge

RELATED: Exclusive: U.S. Government Orders 250,000 Hazmat Suits to be Sent to Dallas

Government agencies across the world are rushing to snap up protective gear as concerns about the spread of the Ebola virus continue to dominate, with Lakeland Industries announcing that it has received 1 million orders for Hazmat suits alone.

Lakeland hit the headlines last month when it was revealed that the U.S. State Department had ordered 160,000 Hazmat suits from the Ronkonkoma, NY company.
The manufacturer saw its stock soar by 30% in after-hours trading on Wednesday after a press release on business activity related to Ebola revealed that the company was still being inundated with orders for Hazmat suits and other PPE items.

“Through its direct sales force and numerous distribution partners throughout the world, Lakeland has secured new orders relating to the fight against the spread of Ebola. Orders have been received from government agencies around the world as well as other public and private sector customers. Certain of these contracts require weekly delivery guarantees or shipments through the first calendar quarter of 2015. The aggregate of orders won by Lakeland that are believed to have resulted from the Ebola crisis amount to approximately 1 million suits with additional orders for other products, such as hoods, foot coverings and gloves,” states the press release.

The company adds that orders for ChemMAX and MicroMAX protective suit lines have increased 50% since August and are on course for a 100% increase by January 2015.

As Infowars reported last week, the federal government is quickly exhausting supplies for Hazmat suits in the United States, with numerous distributors being forced to place stock on hold for “government needs” only as concerns about Ebola linger after a third case was confirmed in New York.

Other federal agencies like the National Institutes of Health are also stockpiling PPE gear in anticipation of an “emergency event” disrupting the supply chain.

Lakeland, which already enjoyed a 40% stock surge in the aftermath of the first Ebola case being confirmed in the United States, is currently selling class A Hazmat suits for $1300 dollars. Business Insider’s Sam Ro accuses the company of cashing in on the spread of the Ebola virus and the fear that has come with it,” noting that the word “Ebola” is mentioned twelve times in their press release.

Bioterrorism Agents/Diseases

Category A

Definition

The U.S. public health system and primary healthcare providers must be prepared to address various biological agents, including pathogens that are rarely seen in the United States. High-priority agents include organisms that pose a risk to national security because they

can be easily disseminated or transmitted from person to person;

result in high mortality rates and have the potential for major public health impact;

Nurse Kaci Hickox defied Maine’s mandatory Ebola quarantine on Thursday and headed out for a bike ride with her boyfriend.

The 33-year-old nurse left her home in Fort Kent, Maine with partner Ted Wilbur this morning, wearing gloves, a safety helmet and couple of layers of fleece to combat the bitter cold.

Miss Hickox broke her quarantine at 9am and took an ATV trail behind her home for the hour-long ride. A state trooper who had been stationed outside the house followed her in a police cruiser.

‘It’s just good to be out,’ Miss Hickox told MailOnline as she left.

Maine police were monitoring her movements and public interactions but there was no court order to arrest the nurse.

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Nurse Kaci Hickox went for an hour-long bike ride on Thursday morning because, she said, ‘there was nothing to stop her’

The 33-year-old nurse went on a bike ride with her partner Ted Wilbur this morning as she defied the mandatory Ebola quarantine placed on her by the state of Maine

The nurse and her boyfriend went for a bike ride on Thursday morning and were trailed by a Maine state trooper who said he was monitoring her actions but had no intention of arresting her

Miss Hickox rides past the unmarked car of a Maine state trooper who followed the nurse but said he had no intention of arresting her

Nurse Kaci Hickox left her home on a rural road in Fort Kent, Maine, to take a bike ride with her boyfriend Ted Wilbur. Police are monitoring her, but can’t detain her without a court order signed by a judge

Maine nurse defies Ebola quarantine with bike ride

As she returned home, she said: ‘There is no court action against me. There is nothing to stop me from going for a bike ride in my home town.’

On Thursday morning I woke to find myself featured in a mini-media firestorm. Why? Because I had shaken the hand of a woman I had just interviewed.

But this wasn’t any woman – it was Kaci Hickox, 33, the nurse who is challenging her 21-day quarantine after returning from treating Ebola victims in Sierra Leone.

Stories were written of our encounter with headlines such as: ‘Nurse breaks quarantine, shakes reporter’s hand’. It was newsworthy because she should not have contact with the public.

I was one of a handful of reporters outside her home in Fort Kent, Maine, when she decided to come outside and talk about her ‘appalling’ confinement.

Under Maine’s official health guidelines she is not supposed to be in public until the three-week period is over. That is not until November 10.

The guidelines are not mandatory but are voluntary. After she made it clear that she doesn’t intend to stick to the rules – which are more stringent than those imposed by the CDC – Maine officials are preparing to secure a court order to force her to stay away from the public.

Defiant Hickox is living with her boyfriend, Ted Wilbur – who has been out and about talking to friends. And on Thursday she went for a bike ride followed by a gaggle of reporters and cameramen.

Despite a state trooper being stationed outside the house, no one tried to prevent people from getting close to her.

Wednesday night’s impromptu press conference was the first time I had been face-to-face with Hickox. Towards the end she bemoaned the fact that despite showing no symptoms of infection, she shouldn’t hug or even shake her hand of people she meets.

On the spur of the moment, I simply said: ‘I’ll shake your hand,’ and I did. It felt like a common courtesy to someone I had just been asking questions of.

It was a brief handshake, nothing memorable, something I have done thousands of times before. She had a firm grip. She looked me briefly in the eye and thanked me.

I turned to leave her property as she and Wilbur went back inside. One local Maine journalist told me he had thought about doing the same but I got there first.

Medical experts say the chances of Hickox falling ill from Ebola are now extremely remote and the risk of transmitting the virus while she is healthy are so slight as to be virtually non-existent – particularly to someone like me who touched her hand so briefly.

President Obama on Wednesday tried to reassure the public that it is safe to touch healthcare workers returning from Ebola ‘hot zones’ when he did the same and shook the hands of doctors and nurses in the 21-day risk period at the White House.

The one question I have been asked repeatedly since is: ‘Did I wash my hands afterwards?’.

Yes I did.

Hickox said that she had not spoken to her lawyers about the ride and it was her decision to go out and get exercise after a day of being cooped up in her house.

The state trooper who followed them by car said he was just monitoring Miss Hickox’s actions and had no intention of arresting her.

The nurse did not say whether she would venture outside again on Thursday, adding that she had to return home to prepare for her daily temperature check for Ebola symptoms from the state’s Center for Disease Control.

Hickox contends there is no need for quarantine because she’s showing no symptoms.

She’s also tested negative for the deadly disease.

Maine Governor Paul LePage told ABC on Thursday that he would give up on the state’s demand to keep the nurse under quarantine if she agrees to take a blood test.

Lawyers for the state of Maine went to court today to ask a judge to order Hickox to take a blood test.

LePage told ABC: ‘This could be resolved today. She has been exposed and she’s not cooperative, so force her to take a test. It’s so simple.’

However, according to Ebola experts, a blood test for Ebola would only be positive if Hickox was displaying symptoms of the virus – which she says she is not.

The Ebola virus is only detectable in the blood if the disease has significantly progressed.

Miss Hickcox has not made it clear whether she would or would not be agree to taking a blood test.

LePage later added that the nurse was causing a lot of tension and worry in the community of Fort Kent.

On Wednesday night, Miss Hickox left the home she has been ordered to stay inside for 21 days in order to speak with the press about her ‘frustrating’ situation.

Standing in front of her boyfriend’s house, as the police tasked with watching her looked on from across the street, Miss Hickox told the waiting media contingent that she will continue to fight her quarantine orders, even if she is charged for breaking them.

‘We have been in negotiations all day with the state of Maine and tried to resolve this amicably, but they are not allowing me to leave my house and interact with the public even though I am completely healthy and symptom free,’ Miss Hickox said, according to The Press Herald.

‘I am frustrated by this fact, and I have been told that it is the Attorney General’s intention to file legal action against me. And if this does occur, I will challenge the legal actions.’

Hickox shook the hand of MailOnline’s reporter at the scene and said: ‘You could hug me. You could shake my hand. I would not give you Ebola’.

The Doctors Without Borders nurse believes she flew into New Jersey from treating dying Ebola patients in West Africa on ‘the wrong day’.

She claimed that many other aid workers have entered the country and continue to do so without having to go through what she had.

Hickox said she remains healthy and has not shown any Ebola symptoms and that the measures she’s being forced to comply with are over-the-top.

However residents of Fort Kent, a small rural, logging community, where she is staying have said that ’21 days (of quarantine) is better is better than 21 deaths’ and that it is a necessary precaution.

‘I’m upset that Chris Christie ever let her go from New Jersey,’ said resident Anne Dugal. ‘He should have kept her there longer.

‘She says she only had a temperature of 101 because she got upset. No-one shows a temperature because they’re upset. She should stay inside.’

Ted Wilbur, Miss Hickox’s boyfriend, had walked over to the police parked across the street from their house on Wednesday to check Hickox would not be arrested for leaving the house.

She did not go any further than the driveway and police remained across the street for the press conference.

MailOnline reporter Martin Gould (pictured right) shakes the hand of nurse Kaci Hickox (left) outside her home in Fort Kent, Maine on Wednesday after she stepped outside to defy the state’s Ebola quarantine

The nurse made a point of going out on an early morning bike ride on Thursday after describing the decision to keep her under quarantine in Maine as ‘appalling’

Miss Hickox returned to her home on Thursday morning trailed by reporters after she made the decision to break her Ebola quarantine

‘Don’t bully me’ Maine nurse who refuses to be quarantined

Hickox said she remains healthy and has not shown any Ebola symptoms and that the measures she’s being forced to comply with are over-the-top.

However residents of Fort Kent, a small rural, logging community, where she is staying have said that ’21 days (of quarantine) is better is better than 21 deaths’ and that it is a necessary precaution.

‘I’m upset that Chris Christie ever let her go from New Jersey,’ said resident Anne Dugal. ‘He should have kept her there longer.

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‘She says she only had a temperature of 101 because she got upset. No-one shows a temperature because they’re upset. She should stay inside.’

Ted Wilbur, Miss Hickox’s boyfriend, had walked over to the police parked across the street from their house on Wednesday to check Hickox would not be arrested for leaving the house.

She did not go any further than the driveway and police remained across the street for the press conference.

Defiant: Kaci Hickox and her boyfriend Ted Wilbur held a press conference outside their Fort Kent, Maine, home at 7pm on Wednesday night, despite orders by the state to stay indoors

State police troopers were stationed outside the Fort Kent, Maine, home of Kaci Hickox on Wednesday after she threatened to break Maine quarantine guidelines – however they are voluntary at the moment so it is unclear whether they would have the authority to arrest her without a court order

Attacks on Hickox have come thick and fast after she told both NBC’s ‘Today’ show and ABC’s ‘Good Morning America’ that she planned to stay in her home on the outskirts of Fort Kent only for one day after being driven back from New Jersey.

Maine Governor Paul LePage stationed state troopers outside the house that Hickox, 33, shares with her boyfriend Ted Wilbur, setting the stage for a showdown should she decide to leave.

The governor’s office did not say whether the nurse would be arrested if she tried to leave, but said state police were stationed outside the home ‘for both her protection and the health of the community’.

The state’s guidelines are voluntary but Governor LePage wants to make it mandatory and enforceable with a court order.

State Health Commissioner Mary Mayhew told reporters in the capital Augusta: ‘When it is made clear by an individual in this risk category that they do not intend to voluntarily stay at home for the remaining 21 days, we will immediately seek a court order.’

According to NBC the hearing is not likely to be held until Monday – the day before LePage faces re-election and four days after Hickox has vowed to leave her home.

‘If I saw her in the street I wouldn’t go near her,’ said Dugal. ‘Twenty one days is not that long a time.’

Novelist Cathie Pelletier, sitting at the next table to Dugal, agreed. ‘It’s not a case that she can say sorry if she is wrong and dozens of people get infected,’ she said. ‘I can’t understand why she can’t just stay at home those extra few days.’

But both the town’s chief of police, Tom Pelletier — Cathie’s third cousin — and Dr. Michael Sullivan, the chief medical officer at Fort Kent’s hospital the Northern Maine Medical Center, said they wanted to shake Hickox’s hand and thank her for the work she has been doing helping the sick.

The conflicting views go to the heart of the confusion surrounding the approach taken by the federal government, the CDC, and individual states to the Ebola crisis and quarantine rules.

They came as many took to Facebook to slam Hickox for refusing to lock herself away for three weeks – and at the medical center where panicked patients are canceling appointments – even though Hickox has gone nowhere near it, the hospital’s boss said.

Hickox and Wilbur returned to their three-bedroom home on the outskirts of Fort Kent under cover of darkness on Tuesday night after a stopover at his uncle’s house in Freeport, Maine.

‘Twenty one days is better than 21 deaths,’ said Anne Dugal (left) as she ate lunch with her mother Dolores in the Swamp Buck Restaurant in Fort Kent on Wednesday. Novelist Cathie Pelletier (right) said: ‘It’s not a case that she can say sorry if she is wrong and dozens of people get infected’

They had driven nearly 500 miles from Newark, New Jersey where she had been held in quarantine following her arrival in the U.S. from Africa.

Hickox, 33, had been treating Ebola sufferers in Sierra Leone with the medical charity Doctors Without Borders.

She has shown no signs of the disease but a forehead thermometer showed she had a slight temperature when she arrived at Newark Liberty International airport, which she has put down to being flustered or a faulty thermometer.

I don’t plan on sticking to the (Maine’s) guidelines. I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public

– Kaci Hickox

Governor Chris Christie departed from national policy and had tried to confine her to a tent inside a hospital for 21 days.

But after she threatened legal action and the White House intervened, she was allowed to travel on the understanding that she would put herself in voluntary isolation in accordance with Maine state guidelines.

Hickox has since declared that she will not be bullied by ‘appalling’ confinement rules and plans to fight for her freedom if restrictions are not lifted by Maine officials on Thursday.

Hickox has said she would abide by all the self-monitoring requirements of the Centers for Disease Control and Prevention. This does not stop people from traveling outside their home, but instead advises them not to go to large gatherings. It also calls on them to take a series of tests twice a day to monitor whether they are developing symptoms.

Doctors insist that the virus is not contagious until symptoms develop.

On Wednesday morning, Hickox, 33, told Today: ‘I don’t plan on sticking to the (Maine’s) guidelines. I am not going to sit around and be bullied by politicians and forced to stay in my home when I am not a risk to the American public.’

Obama May Cut Deportations

Length of Time in U.S., Family Ties to Others in Country Are Expected Criteria

The Obama administration is considering how to decide which illegal immigrants would receive protections, such as those from deportation. WSJ’s Laura Meckler reports. Photo: Getty

By LAURA MECKLER

WASHINGTON—The White House is considering two central requirements in deciding which of the nation’s 11 million illegal immigrants would gain protections through an expected executive action: a minimum length of time in the U.S., and a person’s family ties to others in the country, said people familiar with the administration’s thinking.

Those requirements, depending on how broadly they are drawn, could offer protection to between one million and four million people in the country illegally.

The deliberations follow President Barack Obama ’s promise to act to change the immigration system, after legislation overhauling immigration law died in Congress.

Republicans have protested that Mr. Obama would overstep his authority by acting alone. Several Democratic candidates in tight races also have complained, and last month the president canceled plans to announce the changes before the election.

Mr. Obama, who has been criticized by immigrant-rights advocates for the delay, wants to grant new protections—such as safe harbor from deportation and work permits—to many people who are in the U.S. illegally but have significant ties to the country, said three people familiar with White House thinking.

Such protections would be temporary since the president lacks authority to give people permanent legal status.

One person said officials are leaning toward granting protections to people in the country illegally for 10 years and who meet other criteria, though that could be broadened to include more recent arrivals.

Parents of U.S. citizens are likely to qualify, people familiar with discussions said, as long as they meet other criteria. But it is unclear whether the policy would include parents of so-called Dreamers—people brought to the U.S. illegally as children, and who were given a temporary legal status in 2012.

Also unclear is whether other family ties, such as being married to a U.S. citizen, would qualify somebody for new protections. Illegal immigrants cannot win legal status by marriage unless they return to their home country for a period of years.

The answers to those questions will determine whether up to four million people or as few as just over one million gain protections, according to estimates prepared by the nonpartisan Migration Policy Institute, which the White House has consulted.

White House spokeswoman Katherine Vargas said the president hasn’t made a decision or even received recommendations from his cabinet secretaries. “It is premature to speculate about the specific details,” she said. Still, a mid-December announcement of the change is expected by many immigration experts.

Rep. Mario Diaz-Balart (R., Fla.), who tried to move immigration legislation through the House this year, said executive action would amplify distrust among Republicans in Mr. Obama and make legislating harder. “The right’s going to fly off the rails,” he said. “How do you trust someone who says he does not have the legal authority to do something and then does it anyway?” Mr. Obama previously said that his ability to change immigration law on his own was limited.

White House officials also are considering allowing more young people into the 2012 “Dreamer’’ program that grants temporary legal status and work permits to those who were brought to the U.S. illegally as children, according to two people familiar with discussions. Some 580,000 people were enrolled in the program as of June.

No matter how the White House draws the criteria, the number gaining new protections is certain to be less than the eight million or so who would have benefited from legislation that the Senate passed last year, but that died amid GOP opposition in the House.

Any package along these lines is sure to be attacked by Republicans and possibly some Democrats as presidential overreach. Administration officials say they are working to make sure that whatever they do is legally and politically defensible.

One person people familiar with the process said the White House is trying to craft a plan that survives Mr. Obama’s presidency and isn’t so unpopular that a future Republican president could easily reverse it. “It has to be politically sustainable,” this person said.

One of the most politically sensitive questions is whether to include parents of young people in the Dreamer program, known formally as Deferred Action for Childhood Arrivals. These people are among the most politically active in the immigration debate and are demanding that their parents not be left out.

The president “must be inclusive, and he must be broad, to protect as many people as possible,” said Cristina Jimenez, managing director of the group United We Dream. “Any package of administrative reform must include our parents.”

Republicans have said that broad executive action would kill any chance for immigration legislation next year. Democrats reply that chances already are low that the two parties could come to agreement on a bill. Immigration activists are pressing Mr. Obama to take the most sweeping action possible.

The White House also is expected to change criteria used in deciding who is a priority for deportation. It may, for instance, say a traffic violation doesn’t make someone a priority, though other convictions do. The legal rationale is that the administration lacks the capacity to deport all illegal immigrants and has discretion to set priorities.

Other changes are expected to benefit businesses that use large numbers of legal immigrants, such as technology companies. One change under consideration would “recapture” unused visas from previous years in order to make more visas available to such companies, according to one person familiar with the deliberations. This person said that a second change that companies have requested—changing the way visas are counted so that a family unit counts as only one spot toward the limit—is less likely.

This person said the administration is also considering a change that would make it easier for foreign students to stay in the U.S. after graduation while they await employment-based visas.

White House officials are inclined to wait to announce the new policy until after a must-pass spending bill has cleared Congress, to avoid tangling that legislation with any GOP effort to roll back the immigration policy.

Further, the Louisiana Senate race may not be decided until a Dec. 6 runoff, and White House officials want to avoid injecting immigration into any re-election fight by Sen. Mary Landrieu , a Democrat.

It also is possible that the Georgia Senate race will remain unsolved until an early January runoff, but a senior administration official said there is no thought to pushing the announcement into next year. Mr. Obama has repeatedly vowed to act by year’s end.

Story 1: Good News and Bad News Concerning Ebola — 2 Nurses Ebola Free and 1 Doctor Has Confirmed Case of Ebola in New York City — Ebola Infected Dr. Craig Spencer Took A-Train, L-Train and High-Line – Went Bowling — Contact Tracing Begins — Airborne Ebola Theme Song — If I can make it there, I can make it anywhere, New York, New York — Videos

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Purdue virologist warns Ebola could become airborne

Could Ebola go airborne?

Max Alert! EBOLA Bodily Fluids Readily Airborne Weaponizable

White House Seeking To Reverse New York, New Jersey’s Ebola Quarantine Orders: NYT

US Health Official Criticizes Ebola Quarantine Protocols in NY, NJ

What We Now Know About New York’s First Ebola Case

First Confirmed Ebola Case in New York

Biosafety Level 4 Positive Pressure Spacesuit!

BioContainment Unit at The Nebraska Medical Center

How Infectious Is Ebola? – Nebraska Medicine

New York City, Bellevue Hospital nurse Belkys Fortune, left, and Teressa Celia, Associate Director of Infection Prevention and Control, pose in protective suits in an isolation room, in the Emergency Room of Bellevue Hospital.

Note: They are not wearing a

Biosafety Level 4 Positive Pressure Spacesuit!

(See above photos)

MANDATORY EBOLA QUARANTINE Established in NEW YORK and NEW JERSEY – Mandatory Vaccine Next?

Ebola – The Truth About the Outbreak (Documentary)

EBOLA NYC: Biological Warfare in States

Ebola Theme Song — New York, New York

You Decide

Frank Sinatra-New York,New York

Frank Sinatra-New York,New York-Lyrics

Start spreadin’ the news, I’m leavin’ today
I want to be a part of it
New York, New York
These vagabond shoes, are longing to stray
Right through the very heart of it
New York, New YorkI want to wake up, in a city that never sleeps
And find I’m king of the hill
Top of the heapThese little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New YorkNew York…New York
I want to wake up, in a city that never sleeps
And find I’m A number one, top of the list
King of the hill, A number one….These little town blues, are melting away
I’ll make a brand new start of it
In old New York
If I can make it there, I’ll make it anywhere
It’s up to you, New York..New York New York!!!

Frank Sinatra – New York New York Song **Lyrics** [HD]

My Kind of Town (Chicago) – Frank Sinatra

“My Kind Of Town”

Now this could only happen to a guy like me
And only happen in a town like this
So may I say to each of you most gratef’lly
As I throw each one of you a kissThis is my kind of town, Chicago is
My kind of town, Chicago is
My kind of people, too
People who smile at youAnd each time I roam, Chicago is
Calling me home, Chicago is
Why I just grin like a clown
It’s my kind of town[brief instrumental]My kind of town, Chicago is
My kind of town, Chicago is
My kind of razzmatazz
And it has all that jazzAnd each time I leave, Chicago is
Tuggin’ my sleeve, Chicago is
The Wrigley Building, Chicago is
The Union Stockyard, Chicago is
One town that won’t let you down
It’s my kind of town

New York, New Jersey Set Up Mandatory Quarantine Requirement Amid Ebola Threat Christie: New Policy Has Already Been Used At Newark Liberty International Airport

As CBS 2’s Alice Gainer reported, no other states have yet set up increased screening procedures for Ebola.

“We believe it’s appropriate to increase the current screening procedures from people coming from affected countries from the current (Centers for Disease Control and Prevention screening procedures),” Gov. Andrew Cuomo said Friday afternoon. “We believe it within the State of New York and the State of New Jersey’s legal rights.”

Under the new rules, state officials will establish a risk level by considering the countries that people have visited and their level of possible exposure to Ebola.

The patients with the highest level of possible exposure will be automatically quarantined for 21 days at a government-regulated facility. Those with a lower risk will be monitored for temperature and symptoms, Cuomo explained.

The New York and New Jersey health departments will determine their own specific procedures for hospitalization and quarantine, and will provide a daily recap to state officials on the status of screening, New York State Health Commissioner Dr. Howard Zucker said at the news conference.

The new procedures already have been put into use at Newark Liberty International Airport.

On Friday, a health care worker landed at Newark after treating Ebola patients in West Africa, New Jersey Gov. Chris Christie said at the news conference. A legal quarantine was issued for the woman, who was not a New Jersey resident and was set to go on to New York afterward.

“This woman, while her home residence is outside the area, said her next stop was going to be here in New York,” Christie said. “Governor Cuomo and I discussed it before we came out here, and a quarantine order will be issued.”

The woman will be quarantined in either New York or New Jersey, Christie said.

In discussing the new plan, Cuomo and Christie said a policy of voluntary quarantine simply does not go far enough.

“Voluntary quarantine – you know it’s almost an oxymoron. This is a very serious situation.” Cuomo said. “Voluntary quarantine – raise your right hand and promise you’re going to stay home for 21 days. We’ve seen what happens.”

The new rules were announced a day after Dr. Craig Spencer, a member of Doctors Without Borders, became New York City’s first Ebola patient.

He reported Thursday morning coming down with a fever and diarrhea and is being treated in an isolation ward at Bellevue Hospital, a designated Ebola center.

Spencer returned from West Africa last Friday after treating Ebola patients in Guinea with Doctors Without Borders. He arrived at John F. Kennedy International Airport, passing the extensive CDC screening process.

“When he arrived in the United States, he was also well with no symptoms,” said New York City Health Commissioner Mary Travis Bassett.

Doctors Without Borders said per the guidelines it provides its staff members on their return from Ebola assignments, “the individual engaged in regular health monitoring and reported this development immediately.” But Spencer also took the subway, walked the High Line, and went bowling in Williamsburg, Brooklyn the day before he became sick.

“He was a doctor, and even he didn’t follow the guidelines,” Cuomo said.

With that in mind, the states have to lay down the law, the governors said.

“It’s too serious a situation to leave it to the honor system,” Cuomo said.

The CDC is reviewing its policy for health care workers returning from West Africa, but anyone flying into a Port Authority of New York and New Jersey airport will need to abide by the new procedures.

Ebola Arrives in New York. How Prepared Is the City to Handle It?

Dr. Craig Spencer, the health care worker who recently returned from Guinea and tested positivefor the Ebola virus, is now the first patient to be treated at New York’s Bellevue Hospital.

But the hospital, as well as city, state and federal officials, have been working for weeks or more to ensure the city is ready to identify and treat Ebola cases.

This preparation reflects the now-proven fact that the longer the outbreak rages on in West Africa, the more likely it was that a patient would wind up in Western cities, including New York.

On Oct. 15, the state designated Bellevue Hospital Center as the facility to receive Ebola patients from among the city’s 11 public hospitals, and to receive transferred patients from other hospitals as well, in the event that any Ebola cases occur in the city.

According to a statement from the New York City Health and Hospitals Corporation, the hospital has four single-bed rooms in its infectious disease ward to treat “high probability or confirmed Ebola cases.” This part of the hospital also has a new laboratory that can test for Ebola, separate from the rest of the hospital’s labs, to handle Ebola blood samples.

Because the virus can be spread through contact with an infected person’s bodily fluids, careful handling of blood and other samples is necessary.

The hospital is particularly well suited due to its long history of being on the front lines of epidemics and emerging public health threats, and managing an isolation unit for diseases, such as TB, for many years with support from and collaboration with the City Health Department.

Three other hospitals in New York City have also been designated by the state to treat suspected and confirmed Ebola cases, including Mt. Sinai and New York Presbyterian in Manhattan and Montefiore in the Bronx, according to Governor Cuomo’s Ebola preparedness plan.

None of these hospitals, including Bellevue, has an isolated biocontainment unit like those that have treated patients at Emory University Hospital in Atlanta, Georgia, and Nebraska Medical Center in Omaha, Nebraska.

The American public may not have much faith in ordinary hospitals to treat Ebola, considering that the only non-specialized hospital to treat Ebola patients, Texas Health Presbyterian Hospital Dallas, allowed the virus to spread to two nurses who worked on the original patient, Thomas Eric Duncan, who died of Ebola on Oct. 8. Both of the nurses are now being treated in a biocontainment unit.

The probability of an Ebola case in New York was always considerably higher than it was for many other cities in the U.S., given that two of the city’s international airports — JFK and Newark — are key gateways for travelers to and from West Africa, via stops in Europe or elsewhere in Africa.

“New York City is a frequent port of entry for travelers from West Africa, a home to communities of West African immigrants who travel back to their home countries, and a home to health care workers who travel to West Africa to treat Ebola patients,” The Centers for Disease Control and Prevention (CDC) said in a report on Oct. 17.

“Ongoing transmission of Ebola virus in West Africa could result in an infected person arriving in NYC,” the report said. However, the chance that a New Yorker who has not traveled to an Ebola hotspot would come down with the virus is “extremely slim,” since the disease is only spread through direct contact with an infectious person’s bodily fluids.

Ultimately, it was a doctor who lived in the city who would bring the virus home.

In recent weeks, the New York Health Commissioner issued a “Commissioner’s Order” to all hospitals and ambulance services in the state, “requiring that they follow protocols for identification, isolation and medical evaluation of patients requiring care.”

The state has been conducting “unannounced drills” at hospitals and health care facilities to test preparedness for handling possible Ebola cases. The state has also involved the Metropalitan Transit Authority, which operates the city’s subways and buses, in training for encountering possible Ebola patients.

And a mass Ebola training for health care workers, which included demonstrations for putting on and taking off protective equipment, took place in the city on Oct. 21.

According to new guidelines the CDC issued on Monday, there are now 30 steps health care workers have to take every time they treat a patient with Ebola or Ebola-like symptoms.

At hospitals like Bellevue, actors have played the role of patients with Ebola symptoms have been part of the drills, and the city’s 911 operators have been told to ask people who call in with Ebola-like symptoms if they have recently traveled to West Africa, according to the Guardian.

As of Thursday, there have been nearly 10,000 cases of Ebola in West Africa, along with about 4,900 deaths. However, these figures are likely to be underestimates, since the lack of treatment facilities and other circumstances are causing many patients to go uncounted.

Doctor in New York City Is Sick With Ebola

By MARC SANTORA

A doctor in New York City who recently returned from treating Ebola patients in Guinea became the first person in the city to test positive for the virus Thursday, setting off a search for anyone who might have come into contact with him.

The doctor, Craig Spencer, was rushed to Bellevue Hospital Center and placed in isolation at the same time as investigators sought to retrace every step he had taken over the past several days.

At least three people he had contact with in recent days have been placed in isolation. The federal Centers for Disease Control and Prevention, which dispatched a team to New York, is conducting its own test to confirm the positive test on Thursday, which was performed by a city lab.

While officials have said they expected isolated cases of the disease to arrive in New York eventually, and had been preparing for this moment for months, the first case highlighted the challenges involved in containing the virus, especially in a crowded metropolis. Dr. Spencer, 33, had traveled on the A and L subway lines Wednesday night, visited a bowling alley in Williamsburg, and then took a taxi back to Manhattan.

Photo

Police officers stood outside the apartment of Dr. Craig Spencer on West 147th Street in Harlem on Thursday.CreditJennifer S. Altman for The New York Times

The next morning, he reported having a fever, raising questions about his health while he was out in public. The authorities have interviewed Dr. Spencer several times and are also looking at information from his credit cards and MetroCard to determine his movements.

Health officials initially said that Dr. Spencer had a 103-degree fever when he reported his symptoms to authorities at around 11 a.m. on Thursday. But on Friday, health officials said that was incorrect and that Dr. Spencer reported having a 100.3-degree fever. They said the mistake was because of a transcription error.

People infected with Ebola cannot spread the disease until they begin to display symptoms, and it cannot be spread through the air. As people become sicker, the viral load in the body builds, and they become increasingly contagious.

Mayor Bill de Blasio, speaking at a news conference at Bellevue on Thursday night, sought to reassure New Yorkers that there was no reason to be alarmed.

“Being on the same subway car or living near a person with Ebola does not in itself put someone at risk,” he said.

Dr. Spencer’s work in Africa and the timing of the onset of his symptoms led health officials to dispatch disease detectives, who “immediately began to actively trace all of the patient’s contacts to identify anyone who may be at potential risk,” according to a statement released by the health department.

Photo

Bellevue Hospital Center, where the first person in the city to test positive for Ebola has been quarantined.CreditJoshua Bright for The New York Times

Dr. Spencer’s fiancée has also been quarantined at Bellevue. Two other friends, who had contact with him on Tuesday and Wednesday, have been told by the authorities that they too will be quarantined but whether they will isolate themselves in their homes or be relocated was still under discussion, according to a person briefed on the investigation. None of the three were showing signs of illness.

The driver of the taxi, arranged through the online service Uber, did not have direct contact with Dr. Spencer and was not considered to be at risk, officials said.

Speaking at the news conference, city officials said that while they were still investigating, they did not believe Dr. Spencer was symptomatic while he traveled around the city on Wednesday and therefore had not posed a risk to the public.

“He did not have a stage of disease that creates a risk of contagiousness on the subway,” Dr. Mary Bassett, the city health commissioner, said. “We consider it extremely unlikely, the probability being close to nil, that there will be any problem related to his taking the subway system.”

Still, out of an abundance of caution, officials said, the bowling alley in Williamsburg that he visited, the Gutter, was closed on Thursday night, and a scheduled concert there, part of the CMJ music festival, was canceled. Health workers were scheduled to visit the alley on Friday.

At Dr. Spencer’s apartment building, his home was sealed off and workers distributed informational fliers about the disease.

GRAPHIC

What the New York City Ebola Patient Was Doing Before He Was Hospitalized

Locations visited by Craig Spencer, a Manhattan doctor who has tested positive for Ebola.

OPEN GRAPHIC

Dr. Spencer had been working with Doctors Without Borders in Guinea treating Ebola patients, and completed his work on Oct. 12, Dr. Bassett said. He flew out of the country on Oct. 14, traveling via Europe, and arrived in New York on Oct. 17.

Since returning, he had been taking his temperature twice a day, Dr. Bassett said.

He told the authorities that he did not believe the protective gear he wore while working with Ebola patients had been breached but had been monitoring his own health.

Doctors Without Borders, in a statement, said it provides guidelines for its staff members to follow when they return from Ebola assignments, but did not elaborate on the protocols.

“The individual engaged in regular health monitoring and reported this development immediately,” the group said in a statement.

Dr. Spencer began to feel sluggish on Tuesday but did not develop a feveruntil Thursday morning, he told the authorities. At 11 a.m., he found that he had a 100.3-degree temperature and alerted the staff of Doctors Without Borders, according to the official.

Photo

Mayor Bill de Blasio and Gov. Andrew Cuomo spoke during a press conference at Bellevue Hospital in New York on Thursday.CreditJoshua Bright for The New York Times

The staff called the city’s health department, which in turn called the Fire Department.

Emergency medical workers, wearing full personal protective gear, rushed to Dr. Spencer’s apartment, on West 147th Street. He was transported to Bellevue and arrived shortly after 1 p.m.

He was placed in a special isolation unit and is being seen by the designated medical critical care team. Team members wear personal protective equipment with undergarment air ventilation systems.

Bellevue doctors have been preparing to deal with an Ebola patient with numerous drills and tests as well as actual treatment of suspected cases that turned out to be false alarms.

A health care worker at the hospital said that Dr. Spencer seemed very sick, and it was unclear to the medical staff why he had not gone to the hospital earlier, since his fever was high.

Dr. Spencer is a fellow of international emergency medicine at NewYork-Presbyterian Hospital/Columbia University Medical Center, and an instructor in clinical medicine at Columbia University.

Photo

A photograph of Dr. Spencer on his LinkedIn page.

“He is a committed and responsible physician who always puts his patients first,” the hospital said in a statement. “He has not been to work at our hospital and has not seen any patients at our hospital since his return from overseas.”

Before Thursday, more than 30 people had gone to city hospitals and raised suspicions of Ebola, but in all those cases health workers were able to rule out the virus without performing blood tests.

While the city has stepped up its laboratory capacity so it can get test results within four to six hours, the precautions required when drawing blood and treating a person possibly sick with Ebola meant that it took until late in the evening to confirm Dr. Spencer’s diagnosis.

Doctors said that even before the results came in, it seemed likely that he had been infected. Symptoms usually occur within eight to 10 days of infection. Dr. Spencer stopped working with Ebola patients 11 days ago and returned home six days ago.

Ebola is transmitted through bodily fluids and secretions, including blood, mucus, feces and vomit.

Because of its high mortality rate — Ebola kills more than half the people it infects — the disease spreads fear along with infection.

Several days after his death, a nurse who helped care for Mr. Duncan learned she had Ebola. Two nurses who treated Mr. Duncan fell ill, but are recovering.

That single case led to hundreds of people being quarantined or being asked to remain isolated from the general public.

The missteps by both local and federal authorities in handling the nation’s first Ebola case raised questions about the ability of health care workers to safely treat those with the disease.

In the New York City region, hospitals and emergency workers have been preparing for the appearance of the virus for months.

Dr. Irwin Redlener, the director of the National Center for Disaster Preparedness at Columbia University and a special adviser to Mayor de Blasio, said that the risk to the general public was minimal, but depended on the city moving swiftly.

“New York has mobilized not only a world-class health department, but has full engagement of many other agencies that need to be on the response team,” he said.

Republicans question federal response on Ebola

The new Ebola infection in New York City exposed flaws in the system and raised new concerns, lawmakers said Friday, as they criticised the U.S. government response to the outbreak and questioned top officials’ credibility.

“I can tell you it’s not working. All you need to do is look at Craig Spencer,” said Rep. John Mica, a Republican, naming the doctor in New York who was diagnosed with Ebola late Thursday a week after returning from Guinea. “He was tested there, it’s not working.”

Spencer, the fourth person diagnosed in the U.S., did not exhibit symptoms until Thursday and so the temperature screening in place at the five U.S. airports that receive passengers from Sierra Leone, Guinea and Liberia, the three West African countries that have borne the worst of the outbreak, would not have caught him. Some lawmakers questioning administration officials at a House Oversight and Government Reform Committee hearing said that just showed that a new approach was needed.

Less than two weeks before hard-fought elections, many lawmakers, especially Republicans, have called for a travel ban from the hot spots in West Africa where the deadly disease has infected roughly 10,000 people and killed about half of them. Others have suggested quarantining people for the 21-day incubation period once they arrive.

The Obama administration has resisted, saying such an approach could make things worse by limiting sorely needed supplies and medical workers to West Africa and encouraging travelers to hide their travel histories. Instead the administration has implemented new guidelines for screening all people arriving here from the hot zones and ensuring they’re all monitored by medical experts for 21 days.

Rep. Stephen Lynch, a Democrat, said Friday that anyone who travels here from West Africa should be quarantined for 21 days in their home country before even boarding a plane to the U.S.

“This can’t just be about ideology and happy talk,” Lynch said. “We need to be very deliberate (and) take it much more seriously than I’m hearing today.”

The committee’s chairman, Rep. Darrell Issa, a Republican, complained about wrong information and shifting standards coming from the Centers for Disease Control and Prevention about the first case diagnosed in the U.S., a man who traveled from Sierra Leone to Texas and later died. He infected two nurses who cared for him. As of Friday both nurses have been declared free of the virus.

“We said we were planning to deal with infectious diseases, prepare our health care system and our doctors and nurses,” Issa said. “And in fact it appears as though we trained them but not trained them to the level we should.”

“I think our failures largely relate to the fact that we’re learning some new things about Ebola,” she said. “Ebola’s never been in this hemisphere before, and as we’re learning those things we’re tightening up our policies and procedures as quickly as possible.”

In her prepared testimony, Lurie assured lawmakers that a large-scale outbreak of Ebola is unlikely in this country. “There is an epidemic of fear, but not of Ebola, in the United States,” she said.

Race on to decontaminate Ebola doctor’s NYC home

By Kevin Fasick and Chris Perez

New York City police officers enter the building where Dr. Craig Spencer (inset with fiancée Morgan Dixon) lives in New York on Oct. 24.Photo: Reuters/Mike Segar

Efforts are under way to decontaminate the apartment building of the Big Apple’s first Ebola patient.

Cops moved people back around 9:15 am as two officers with the Sanitation Department’s Environmental Police Unit arrived on the scene and entered the building through a side entrance.

They were later joined by several people in plain-clothes who exited out of a truck belonging to the Bio-Recovery Corporation — a full service crime scene cleanup and bio remediation company.

“Today we’re expecting a specialized crew [to] come in full protective gear and will clean and sterilize Dr. [Craig] Spencer’s apartment for signs of bodily fluid,” said City Council member Mark Levine, adding that officials would “confiscate material that might have come into contact with his body such as sheets and pillowcases and bath towels and toothbrushes.”

The 7th District councilman was on the scene Friday morning, giving updates specifically aimed at people in the community whose fears were heightened Thursday when Spencer, a Doctors Without Borders volunteer, tested positive for the Ebola virus.

“We’ve had neighbors understandably concerned that live right across the street, maybe they live down the hall, maybe they’ve seen him in the local bodega and they’re worried,” he told the crowd. “But the truth is and the facts they need to understand are they’re really not at risk.”

Police and health officials enter the New York apartment building of Dr. Craig Spencer, who has been diagnosed with the Ebola virus, on Oct. 24.

EPA/Andrew Gombert

Levine made it clear that while fear of catching the disease was high, the actual possibility that Spencer could have spread the illness before being hospitalized was minimal.

“If he was well enough to go for a run, then he was almost certainly not sick enough to be contagious,” he said. “Frankly, if he was well enough to go bowling, he was probably not sick enough to be contagious, so people should not worry.”

When Spencer first reported his elevated temperature to officials, firefighters worked quickly to make sure the risk of infection was extremely low.

“The first thing they did was seal off the apartment,” he said. “That happened immediately after Dr. Spencer was taken to the ambulance.”

A neighbor who lives across from Spencer told The Post that four of his relatives panicked shortly after the Harlem doctor was picked up and eventually left the apartment.

“They’re gone, they weren’t moved by the authorities, they left on their own because of the scare, because they were frightened,” said Stan Malone, 45. “This really hits home … I believe it’s gonna get worse.”

Malone added that while he thought Spencer had only come in contact with a few people, he felt the city wasn’t doing enough to ensure the safety of New Yorkers.

“I think this whole building should be quarantined now,” he said. “What’s taking the city so long to do that?”

Another doctor who treated Ebola came through JFK

By Philip Messing and Lorena Mongelli

A physician who treated dying Ebola patients in Liberia flew in to JFK on Thursday night — and stayed at an airport hotel, a source told The Post.

Colin Bucks, a clinical assistant professor at Stanford University’s medical school, arrived on a Royal Moroccan Air flight, sources said.

He spent the night at the Hilton Garden Inn in Jamaica, Queens, where Centers for Disease Control workers also stay, according to a source.

On Friday, he was cleared to travel home to Northern California, where he will “be monitored by CDC there,” the source said.

“He is asymptomatic and he’s being allowed to leave the hotel and fly home,” a source added.

Sources said that Bucks, who works with International Medical Corps, was told to self-quarantine at the hotel, but he told The Post he merely missed a connecting flight. He said he was screened at the airport in Africa and again upon arrival at Kennedy airport.

“If there had been a flight yesterday, I would’ve not spent the night here,” he said in a telephone interview.

Bucks is strictly following the CDC’s recommendations and self-monitoring, he said. The CDC is also keeping track of his whereabouts, as standard protocol dictates, he added.

“I worked for over a month with no national staff or ex-patriot staff showing any signs of illness,” he said. “In general I’m amazed by the national staff I was working with. I really want them to be viewed as the heroes of Ebola response.

Bucks didn’t know Spencer, but said, “It sounds like this is someone who’s cut from the same cloth as me who followed all the rules and has not put other people at risk.”

He’s confident that by following proper guidelines, health care workers can do life-saving work abroad and stay safe.

“I have every confidence that [by] following CDC return recommendations, nurses, doctors, lab technicians can go to West Africa and do what’s necessary to protect the rest of the world and not come back and be the ones that need protection.”

On Friday afternoon, the governors of New York and New Jersey announced extra measures that will require all at-risk passengers touching down at JFK and Newark Liberty airports from Ebola-stricken countries to be quarantined for 21 days.

Transmission

Because the natural reservoir host of Ebola viruses has not yet been identified, the way in which the virus first appears in a human at the start of an outbreak is unknown. However, scientists believe that the first patient becomes infected through contact with an infected animal, such as a fruit bat or primate (apes and monkeys), which is called a spillover event. Person-to-person transmission follows and can lead to large numbers of affected people. In some past Ebola outbreaks, primates were also affected by Ebola, and multiple spillover events occurred when people touched or ate infected primates.

When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with

blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola

objects (like needles and syringes) that have been contaminated with the virus

infected fuit bats or primates (apes and monkeys)

Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only a few species of mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.

Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients.

During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.

Dedicated medical equipment (preferable disposable, when possible) should be used by healthcare personnel providing patient care. Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.

Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. Abstinence from sex (including oral sex) is recommended for at least 3 months. If abstinence is not possible, condoms may help prevent the spread of disease.

As the death toll from Ebola reaches 3,800, experts are warning that the virus could mutate and become airborne, meaning that it could be caught by breathing it in.

The public is being told by health officials that the virus that causes Ebola cannot be transmitted through the air and can only be spread through direct contact with bodily fluids – blood, sweat, vomit, feces, urine, saliva or semen – of an infected person who is showing symptoms.

However, several leading Ebola researchers claim that the virus mutating and spreading through the air should not be ruled out.

As the death toll from Ebola reaches 3,800, experts are warning that the virus could mutate and become airborne

Virus expert Charles L. Bailey, who in 1989 helped the American government tackle an outbreak of Ebola among rhesus monkeys being used for research, told the LA Times: ‘We know for a fact that the virus occurs in sputum and no one has ever done a study [disproving that] coughing or sneezing is a viable means of transmitting.

‘Unqualified assurances that Ebola is not spread through the air are “misleading”.’

Dr C J Peters, who has undertaken research into Ebola for America’s Centers for Disease Control and Prevention, told the paper: ‘We just don’t have the data to exclude it [becoming airborne].’

Meanwhile virologist Dr Philip K Russell, a former head of the U.S Army’s Medical Research and Development Command, told the paper: ‘I see the reasons to dampen down public fears. But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man…. God knows what this virus is going to look like. I don’t.’

In September, Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, writing in the New York Times, said experts who believe that Ebola could become airborne are loathed to discuss their concerns in public, for fear of whipping up hysteria.

Discussing the possible future course of the current outbreak, he said: ‘The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air.’

The public is being told by health officials that the virus that causes Ebola cannot be transmitted through the air and can only be spread through direct contact with bodily fluids

Defence Secretary won’t talk about UK airport Ebola screening

Dr Osterholm warns viruses similar to Ebola are notorious for replicating and reinventing themselves.

It means the virus that first broke out in Guinea in February may be very different to the one now invading other parts of West Africa.

Pointing to the example of the H1N1 influenza virus that saw bird flu sweep the globe in 2009, Dr Osterholm said: ‘If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola.’

Dr Osterholm said public health officials, while discussing the possibility in private, are reluctant to air their concerns.

Ebola virus: Five facts you didn’t know about the disease

Virus expert Charles L. Bailey said unqualified assurances that Ebola is not spread through the air are ‘misleading’

The suit that can save lives: British-made Ebola protection suits

‘They don’t want to be accused of screaming “Fire!” in a crowded theater – as I’m sure some will accuse me of doing.

‘But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.’

He called for the United Nations to mobilise medical, public health and humanitarian aid to ‘smother the epidemic’.

The chair of the UK’s Health Protection Agency, Professor David Heymann of the London School of Hygiene of Tropical Medicine, said it is impossible to predict how any virus will mutate.

He said scientists across the world do not know enough about genetics to be able to say how the Ebola virus will change over time.

He told MailOnline: ‘No one can predict what will happen with the mutation of the virus. I would like to see the evidence that this could become a respiratory virus.’

The first person diagnosed with Ebola in the U.S. died on Wednesday despite intense but delayed treatment, and the government announced it was expanding airport examinations to guard against the spread of the deadly disease.

The checks will include taking the temperatures of hundreds of travelers arriving from West Africa at five major American airports.

The new screenings will begin Saturday at New York’s JFK International Airport and then expand to Washington Dulles and the international airports in Atlanta, Chicago and Newark. An estimated 150 people per day will be checked, using high-tech thermometers that don’t touch the skin.

The White House said the fever checks would reach more than 9 of 10 travelers to the U.S. from the three heaviest-hit countries – Liberia, Sierra Leone and Guinea.

President Barack Obama called the measures ‘really just belt and suspenders’ to support protections already in place. Border Patrol agents now look for people who are obviously ill, as do flight crews, and in those cases the Centers for Disease Control and Prevention is notified.

As of Wednesday, Ebola has killed about 3,800 people in West Africa and infected at least 8,000, according to the World Health Organization.

A medical official with the U.N. Mission in Liberia who tested positive for Ebola arrived in the German city of Leipzig on Thursday to be treated at a local clinic with specialist facilities, authorities said.

The unidentified medic infected in Liberia is the second member of the U.N. mission, known as UNMIL, to contract the virus. The first died on September 25. He is the third Ebola patient to arrive in Germany for treatment.

The virus has taken an especially devastating toll on health care workers, sickening or killing more than 370 of them in the hardest-hit countries of Liberia, Guinea and Sierra Leone – places that already were short on doctors and nurses.

There are no approved medications for Ebola, so doctors have tried experimental treatments in some cases, including drugs and blood transfusions from others who have recovered from Ebola.

The survivor’s blood could carry antibodies for the disease that will help a patient fight off the virus.

Experts raise specter of more-contagious Ebola virus

Osterholm mentioned the risk of Ebola migrating to developing-world megacities like Nairobi, Kenya.

Amid fears that West Africa’s Ebola epidemic may spiral out of control, two experts are using the pages of leading newspapers to raise the specter of a mutant Ebola virus that could become airborne, and appealing for massive interventions to preclude that nightmare scenario.

Michael T. Osterholm, PhD, MPH, wrote in a New York Times commentary today that the scale of the epidemic is offering the virus unprecedented opportunities to evolve toward greater transmissibility, which could give it the capability to spread worldwide. He is director of the University of Minnesota’s Center for Infectious Disease Research and Policy, publisher of CIDRAP News.

Richard E. Besser, MD, chief health editor at ABC News and a former acting director at the Centers for Disease Control and Prevention (CDC), wrote in the Washington Post last night that a more-contagious Ebola virus could threaten the United States and said the crisis warrants the deployment of thousands of American troops to the affected countries.

What virologists don’t like to talk about

The possibility of an airborne-transmissible Ebola virus is one “that virologists are loath to discuss openly but are definitely considering in private,” wrote Osterholm. In its current form, the virus spreads only through contact with bodily fluids, he noted, but with more human transmission in the past few months than probably occurred in the past 500 years, the virus is getting plenty of chances to evolve.

“Each new infection represents trillions of throws of the genetic dice,” he said.

“If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.”

Osterholm added that public officials are reluctant to talk about this risk because they fear being accused of screaming “Fire!” in a crowded theater. “But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.”

As evidence of the risk, he noted that Canadian researchers in 2012 showed that Ebola Zaire, the species in the West African epidemic, could spread by the respiratory route from pigs to monkeys.

Even without airborne Ebola contagion, there’s a risk of Ebola migrating to developing-world megacities such as Nairobi, Kinshasa, or Karachi, possibly touching off new epidemics, Osterholm wrote.

In the face of the grave risks, someone needs to exercise “command and control,” and the best candidate is the United Nations, he asserted.

The UN “is the only international organization that can direct the immense amount of medical, public health, and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic. Thus far it has played at best a collaborating role, and with everyone in charge, no one is in charge.”

Besser: US must take the lead

Besser, in appealing for a vastly greater Ebola response from the United States, sketched bleak scenes of sick people in Monrovia, Liberia, waiting to get into overcrowded treatment centers and burial teams trying to collect bodies from the homes of terrified people who deny that their loved ones died of Ebola.

Recalling the warning last week from current CDC Director Tom Frieden, MD, MPH, that the window of opportunity to stop the epidemic is closing, Besser wrote, “I don’t think the world is getting the message. The magnitude of the response needed for a deadly outbreak like this in a staggeringly poor country demands both dollars and people.”

He said his CDC experience taught him that “a military-style response during a major health crisis saves lives.” In foreign public health emergencies, the CDC usually provides technical support to governments, but “this crisis calls for much more.”

Noting that the epidemic is threatening the stability of the affected countries, Besser asserted that an expanded American response would improve both global security and health security.

“While one Ebola case in the United States is unlikely to spark an outbreak, things could change if the virus becomes more easily transmittable,” he added. “We already know it’s mutating.” He called the outbreak more disturbing than anything he witnessed in 13 years at the CDC.

Besser welcomed recent moves to scale up US aid to West Africa, including the Obama administration’s request for more funds, but he said much more is needed.

He called for large field hospitals staffed by Americans to treat Ebola patients, plus active US involvement in strengthening infection control, staffing burial teams, and detecting new cases.

“A few thousand U.S. troops could provide the support that is so desperately needed,” he added. “There could be casualties, but what military operation is ruled out solely because it is dangerous?”

“We know how to control Ebola. It’s time to step up and get the job done,” he concluded.

MSF president speaks out

Some similar points were made in another Washington Post commentary, this one from Joanne Liu, MD, president of Doctors without Borders (MSF), the leading private aid group fighting Ebola in West Africa.

Using words similar to those she used at a UN briefing last week, Liu described the grim situation in West Africa and said MSF has been “completely overwhelmed.”

“We need a large-scale deployment of highly trained personnel who know the protocols for protecting themselves against highly contagious diseases and who have the necessary logistical support to be immediately operational. Private aid groups simply cannot confront this alone,” she wrote.

What We’re Afraid to Say About Ebola

By MICHAEL T. OSTERHOLMSEPT. 11, 2014

THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.

There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, theWorld Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time.

There are two possible future chapters to this story that should keep us up at night.

The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. This outbreak is very different from the 19 that have occurred in Africa over the past 40 years. It is much easier to control Ebola infections in isolated villages. But there has been a 300 percent increase in Africa’s population over the last four decades, much of it in large city slums. What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.

Why are public officials afraid to discuss this? They don’t want to be accused of screaming “Fire!” in a crowded theater — as I’m sure some will accuse me of doing. But the risk is real, and until we consider it, the world will not be prepared to do what is necessary to end the epidemic.

In 2012, a team of Canadian researchers proved that Ebola Zaire, the same virus that is causing the West Africa outbreak, could be transmitted by the respiratory route from pigs to monkeys, both of whose lungs are very similar to those of humans. Richard Preston’s 1994 best seller “The Hot Zone” chronicled a 1989 outbreak of a different strain, Ebola Reston virus, among monkeys at a quarantine station near Washington. The virus was transmitted through breathing, and the outbreak ended only when all the monkeys were euthanized. We must consider that such transmissions could happen between humans, if the virus mutates.

First, we need someone to take over the position of “command and control.” The United Nations is the only international organization that can direct the immense amount of medical, public health and humanitarian aid that must come from many different countries and nongovernmental groups to smother this epidemic. Thus far it has played at best a collaborating role, and with everyone in charge, no one is in charge.

A Security Council resolution could give the United Nations total responsibility for controlling the outbreak, while respecting West African nations’ sovereignty as much as possible. The United Nations could, for instance, secure aircraft and landing rights. Many private airlines are refusing to fly into the affected countries, making it very difficult to deploy critical supplies and personnel. The Group of 7 countries’ military air and ground support must be brought in to ensure supply chains for medical and infection-control products, as well as food and water for quarantined areas.

The United Nations should provide whatever number of beds are needed; the World Health Organization has recommended 1,500, but we may need thousands more. It should also coordinate the recruitment and training around the world of medical and nursing staff, in particular by bringing in local residents who have survived Ebola, and are no longer at risk of infection. Many countries are pledging medical resources, but donations will not result in an effective treatment system if no single group is responsible for coordinating them.

Finally, we have to remember that Ebola isn’t West Africa’s only problem. Tens of thousands die there each year from diseases like AIDS, malaria and tuberculosis. Liberia, Sierra Leone and Guinea have among the highest maternal mortality rates in the world. Because people are now too afraid of contracting Ebola to go to the hospital, very few are getting basic medical care. In addition, many health care workers have been infected with Ebola, and more than 120 have died. Liberia has only 250 doctors left, for a population of four million.

This is about humanitarianism and self-interest. If we wait for vaccines and new drugs to arrive to end the Ebola epidemic, instead of taking major action now, we risk the disease’s reaching from West Africa to our own backyards.

Michael T. Osterholm is the director of the Center for Infectious Disease Research and Policy at the University of Minnesota.